At BioPed Footcare, people of all ages and all walks of life visit our clinic’s lower limb clinicians for help with foot and lower limb pain and discomfort. As a part of BioPed’s multidisciplinary team of Certified Pedorthists, Footcare Nurses and Registered Chiropodists, we enjoy providing footcare for new clients and for those they have known for years. By increasing comfort and function, we strive to improve the quality of life for all our clients.
A few weeks ago, a new client to one of our BioPed clinics called to book an appointment as they were suffering with pain and discomfort in both of their heels. At the start of their assessment, we sat down together and heard about their new passion for getting into shape and achieving a more healthy body weight. This passion drove them to get outside and get going hard and fast! Unfortunately, exercising and training that is not done gradually and in increments can cause unexpected and unwanted injury.
This client was so eager to get started, they dug out a pair of old running shoes last worn almost a decade ago. They felt comfortable at first while walking around the house, but after a week of running on concrete neighbourhood sidewalks, their heel pain became increasingly worse. When questioned, they indicated the pain was worse when they first got out of bed in the morning, with the pain easing up slightly as the day progressed. When they booked this appointment, they were asked to bring in the running shoes they had been wearing. At first glance we noticed these shoes were worn out and had lost their integrity, including the support and cushioning they may have had at one point years ago.
Heel pain is one of the most common foot complaints we treat in our BioPed clinics. Plantar fasciitis is often the culprit of heel pain and can result for a variety of reasons including a sudden increase in activity level, new or overused footwear, transitioning from indoor to outdoor training or recent weight gain. It is usually concentrated on the bottom centre of the heel where the plantar fascia inserts onto the heel bone. The plantar fascia is a strong band of connective tissue that is attached to the bottom of the heel bone and extends to the toes. It acts as a truss or support for the arch and foot. If left untreated, a bone spur on the heel may develop over time.
During an appointment like this, a biomechanical assessment and gait analysis are always conducted in order to figure out what is going on in a person’s lower body mechanics and how we can help them heal and perform better. This particular client had a higher than normal arch and when they walked we noticed a heavy heel strike. Naturally this client was guarded when walking that day during their assessment as their heels were sore with every single step.
How did we address this heel pain?
The pain this client experienced was caused by inflammation. R.I.C.E is a well-known combination of rest, ice, compression and elevation. The first recommendation we made was taking a rest from running to prevent further trauma to the insertion site of the plantar fascia. We also advised this client to apply ice or cold therapy directly to the heel. Inflammation causes an increase in temperature therefore ice and cold counteract. Freezing a water bottle and rolling it under the heel will deliver cold therapy and massage at the same time. Massage balls can be purchased at all BioPed clinics and are effective in breaking up scar tissue that may have formed with the inflammatory process. The Orthosleeve FS6 helps ease and reduce swelling with 6 zones of compression to increase circulation and reduce inflammation. If done properly, stretching can also be helpful to increase flexibility and keep the soft tissue supple which can help heal an injury and prevent a new one from forming.
his client of ours had reduced shock absorption when walking and running and we decided to prescribe and make them custom foot orthotics (CFOs). We designed their CFOs to help control the amount of rotation in their heels and add needed shock absorption in the lower body. Our overall goal was reducing the strain on the plantar fascia. The importance of properly fitted and activity-specific footwear must never be underestimated. It is vital to remember that not all shoes are created equal! Our client’s running shoes were worn out and not benefiting them whatsoever. Not only did we fit them for a new pair of running shoes with cushioning and stability features suitable for their fitness journey, we also recommended wearing an indoor pair of shoes or sandals with a moulded footbed around their home. Suffering with an acute episode of plantar fasciitis like our client was, it was imperative to have supportive footwear with a stable platform under their feet at all times. At BioPed, we have many options to choose from and will always take the time to find the best fit for you!
After a week of R.I.C.E and wearing supportive footwear at all times, our client’s pain started to dissipate. After sufficient healing was well underway, we gave the go ahead to start running again wearing their new CFO and running shoe combination. We discussed guidelines for training and how to do so safely to avoid re-injury and downtime.
If you’ve tried all the aforementioned treatments and are still suffering with plantar fasciitis, a cortisone injection could help. This injection delivers an anti-inflammatory steroid directly to the site which ensures the medicine will work where it needs to work. There are minor risks with a treatment like this such as infection, numbness and fascial rupture. Most importantly, always remember pain is not normal. If you are suffering with heel pain, book an appointment at your local BioPed with one of our lower limb clinicians today to determine the cause of your pain and the best treatment(s) for you!
If you are suffering from heel pain or any other type of lower body pain, call BioPed Footcare today to make an appointment to discuss treatment options designed specifically for you to help you do more in life!
